The confusing ethics of resuscitation science

Even though DNR (Do Not Resuscitate) bracelets have been available in the U.S. for years, I have a feeling there will always be controversy surrounding whether a patient can/should refuse critical care. Especially in cases of unforeseen emergency. Imaginative methods of preventing heroic lifesaving measures will continue to challenge the law until we can come up with a foolproof system everyone is comfortable with. But since attitudes towards what would constitute compassionate treatment differ wildly when it comes to extreme paralysis, coma, or chronic pain, I hold little hope we’ll reach an agreement in my lifetime. Ask any Ambulance Driver and they will tell you even the study of resuscitation is an inexact science that requires a patient’s ignorance:

“We will never know the best way to treat people unless we do this research. And the only way we can do this research, since the person is unconscious, is without consent,” said Myron L. Weisfeldt of the Johns Hopkins University School of Medicine, who is overseeing the project. “Even if there are family members present, they know their loved one is dying. The ambulance is there. The sirens are going off. You can’t possibly imagine gaining a meaningful informed consent from someone under those circumstances.”

Which means depending on where you live, it really may not matter if you carry a card, have a tattoo or sign a Medical Directive since the rule for an EMT based on protocol is resuscitate first, ask questions later. This is also why DNR’s are usually reserved for patients with terminal illnesses who wish to die without invasive medical procedures rather than for people experiencing heart trauma or other medical emergencies. Ultimately (and frustratingly for some of us) it seems the only fail-proof (?) method is trusting your eventual caregivers to know your desires and be strong enough emotionally to fight for your rights, if it ever comes to that. (via BoingBoing)

UPDATE: In a related story, the Washington Post reports on a New York Ambulance service for recovering your organs if EMTs can’t save you. While organ donation is desperately needed, of course it makes people suspicious: “I think it’s disgusting,” said Michael A. Grodin, director of bioethics at Boston University. “People are going to worry when the ambulance comes out to their house whether they are there to care for them or to take their organs.”